Positive Air, Inc.
3312 Marquart St., Houston, TX 77027
(866) 923-2727 (281) 840-4504
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CPAP & OXYGEN CLIENTS' BILL
OF RIGHTS AND RESPONSIBILITIES
Positive Air, Inc. believes that you, the patient, are
entitled to be treated with dignity and respect, to participate
in your plan of care and to make informed decisions regarding
your continued care. In order for us to insure this occurs, we
provide you with the following:
Mission Statement
The staff of Positive Air, Inc. is dedicated to providing
the highest quality of patient care available in our industry.
Included in this goal, is the knowledge that we have provided
quality services and products for over 30 years. Our philosophy
is simple – provide the level of service we, ourselves would
expect. To accomplish quality patient care requires all of us
working together as a team. This team includes not only the
employees of Positive Air, but the patients and our referral
sources as well. We depend upon our patients and referral
sources to evaluate our performance – good or bad. There are
numerous companies in this field that can provide the same
equipment; we strive to provide quality care. REMEMBER: Together
Everyone Achieves More – TEAM.
We will provide service without regard to race, creed,
gender, age, handicap, sexual orientation or veteran status.
You have the right to have information regarding the
services, products and equipment provided to you or available
for you. Simply ask our customer service department or your
service technician for information concerning other items we can
provide to you. You have the right to receive services in a
timely and consistent manner. Information is to be provided to
educate you on the proper use of your equipment. You may contact
us at (713) 840-9599 or (800) 231-0443, if your equipment is
not working properly.
Positive Air, Inc. is a family owned and operated
corporation, which has been in business since 1971.
If your care is being provided through Medicare, your
charges will be sent directly to Medicare for payment. A portion
of the charges should be covered and you, the patient are
responsible for the remainder; unless there is additional
insurance coverage involved. For Medicaid, coverage should be
100% as long as you qualify.
If your care
is being provided through a private insurance policy, the policy
will control as to the patient 's coverage and financial
responsibility. Each plan is different so make certain to check
with your specific plan.
If there are
any changes to your particular billing situation we will contact
you as soon as we are made aware of any changes. Likewise, you
are responsible for notifying us of any changes to your
insurance situation. Please be advised that ultimately you are
financially responsible for payment for the services provide.
You will receive an itemized bill for any charges you are
financially responsible for.
You have the
right to be free from any mental, physical abuse, neglect or
exploitation of any kind. You also have the right to have
protective services offered to you.
You have the
right to prepare advance directives (means to communicate your
wishes regarding medical treatment in the event you cannot
communicate your wishes). We will provide advance directive
forms upon your request to our Customer Service Supervisor.
Services will be provided based upon those directives, as
provided to us. You will receive services without regard to
whether or not any advance directives have been executed.
Our entire
staff strives to provide you with excellent care and services,
if we fail to provide this, please do not hesitate to let us
know. You may contact our main office in Houston, Texas at (713)
840-9599 or (800) 231-0443 and ask to speak to the Customer
Service Supervisor (for patient care issues), Accounts
Receivable Supervisor (for billing issues) or the Office
Manager.
You also have
the right to register a complaint about care or treatment with
the State, Medicare, Center for Medicare and Medicaid Services.
You have the right to have a grievance documented, and receive a
response regarding the investigation and resolution if you
request.
You have the
right to confidentiality of your records and to obtain this
information within a reasonable time frame. We do not share this
information with any entity, other than to the extent necessary
to obtain reimbursement for the services we provide. We will
disclose any beneficial relationship where we receive
reimbursement for providing our services.
The services
we provide should make you more comfortable, but it will not
cure any illness you might have. This equipment is not to
replace any required visits to your physician. The employees of
Positive Air, Inc. are not physicians; therefore, we cannot take
the place of your physician and cannot change or alter their
orders.
You are
required to notify for the following changes: your address
changes, your insurance information changes or your physician
changes.
All equipment
is for your specific use. Please do not share this equipment
with others. This equipment is not to be operated by minors and
should be kept secure in their presence.
If you
require any additional information, please contact us at (713)
840-9599 ext. 144, write us at Positive Air, Inc. 3312 Marquart
Street, Houston, Texas 77027, attn: quality improvement or
e-mail us at
charles.goldberg@positiveair.com.
Upon written request, we will provide additional information.
THIS EQUIPMENT IS
NOT CONSIDERED LIFE SUSTAINING; IF A SERIOUS HEALTH PROBLEM
RESULTS YOU MUST CONTACT YOUR PHYSICIAN OR EMERGENCY SERVICES
IMMEDIATELY. DO NOT CONTACT POSITIVE AIR, INC.
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Positive Air, Inc. featuring CPAP & Portable
Oxygen Concentrators from Resmed, Respironics, Puritan Bennett,
Fisher & Paykel, Inogen, & SeQual Copyright 2007
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